Lesiones precancerosas de la mucosa oral

La alta incidencia del cáncer oral (entre el 4,5 por ciento y el 11 por ciento según diferentes autores) hace que el diagnóstico precoz de esta enfermedad sea una necesidad perentoria con el fin de que su tratamiento sea lo más eficaz y lo menos mutilante posible. La facilidad de exploración de la cavidad oral hace que este diagnóstico no deba ser responsabilidad exclusiva de los odontoestomatólogos, sino que el médico general debe conocer aquellas lesiones que asentando sobre la cavidad oral puedan conducir en su evolución a un cáncer oral. No se debe hablar de forma genérica sobre precáncer oral, sino que hemos de distinguir entre condiciones o estados precancerosos y lesiones precancerosas (AU)

Neuroblastoma. A study of the clinicopathological features influencing prognosis based on the analysis of 54 cases.

The retrospective analysis of 54 cases of neuroblastoma taken from the files of the Department of Pathology, University of Santiago Hospital, Spain, and the Ludwig-Aschoff Institute of Pathology, University of Freiburg, Germany confirmed the validity and significance of various clinical and histopathological features when trying to establish the prognosis and the proper therapeutic approach in a given case of neuroblastoma. When the age of the patients was compared to survival it was shown that all but three of the patients older than 2 years of age had died from tumor within ten months. In contrast, there was a 37.5% five-year survival rate among patients who were 24 months of age or younger at the time of diagnosis and treatment. The primary tumor was located in the adrenal gland in 27 cases (50%), in 9 cases (17%) the tumor was retroperitoneal but extra-adrenal, and in the remaining 18 patients (33%) the tumor arose from the paravertebral sympathetic ganglia. Adrenal primaries behaved in an extremely aggressive manner as all but three patients with tumors at this location were dead within 18 months. Retroperitoneal extra-adrenal neuroblastomas followed an almost equally poor outcome with only one five-year survivor (11%). In contrast, 49% of the patients with paravertebral neuroblastoma had survived five years and a further 33% were alive with shorter follow-up. According to histological criteria, there were 6 grade I tumors, 15 grade II and 33 grade III tumors in our series. All grade I tumors were clinical stage I at diagnosis and all are alive 2 to 3 1/2 years later.(ABSTRACT TRUNCATED AT 250 WORDS)

Uterine müllerian adenosarcoma with histiocytic (xanthomatous) mesenchymal component.

We present an endometrial Müllerian adenosarcoma in which the sarcomatous component showed prominent nests of foamy cells that accounted for 50% of the neoplastic mesenchyma. Such foamy cells showed occasional cytological atypias and immunohistochemical features of histiocytic (macrophagic differentiation in the absence of changes that could substantiate the presence of an inflammatory infiltration of foamy histiocytes. These facts suggest histiocytic differentiation from neoplastic mesenchymal cells. Such differentiation has been reported in association with malignant mixed mesodermal tumor, but not in Müllerian adenosarcoma.

Intracystic carcinoma of the breast. A clinicopathologic entity.

Two intracystic breast carcinomas with papillary pattern, one of which was argyrophilic, are reported, and their peculiar clinical features emphasized. The confusing terminology used in literature is also discussed. The fainly well-defined clinico-pathological features of these tumors allow them to be classed as a specific clinico-pathological variety of ductal breast carcinoma. The immunohistochemical study, which was negative to ALA, ACTH, GH, PRL and NSE, led us to consider the potential mucoid nature of the argyrophilic granules.

[Tricuspid atresia with hypoplasia of aortic isthmus in absence of transposition of great vessels (author's transl)]. / Atresia tricúspide con hipoplasia del istmo aórtico en ausencia de transposición de los grades vasos.

A case of tricuspid atresia with a concordant ventriculoarterial connection associated with hypoplasia of the aortic isthmus and malformation of left atrioventricular valve is presented. Hyoplasia of aortic isthmus in absence of transposition of great vessels was explained by a posterior deviation of infundibular septum that reduced subaortic outflow tract and created an ample bulboventricular orifice. In the left atrioventricular valve an anterolateral papillary muscle that was prolonged in a thick chorda tendineaee fused to ventricular face of the cusp up to its insertion in the atrioventricular ring was observed. A systolic murmur of high tonality compatible with regurgitation of the left atrioventricular valve and a notch that was registered in postmortem angiography were attributed to this anomalous chorda tendinea. In the posterior wall of the heart there were two descending coronary arteries. One descended fro the crux cordis; the other, to its right, adjacent ot the acute margin, followed the insertion of the trabecular septum, delimited the outlet chamber, and was anastomosed to the anterior descending coronary artery.

[Systolic honk and blood cyst of the tricuspid valve in an infant (author's transl)]. / honk"honk"

A case of a one month old girl admitted in hospital because of cardiac failure who died at three months of age is described. Her necropsy demonstrated a ventricular septal defect and showed a blood cyst in the tricuspid valve. It might be possible that the "precordial honk" or "whoop" heard during life, the cottony, shaggy pictures recorded in the echocardiogram behind the anterior tricuspid leaflet in diastole, the tricuspid regurgitation appreciated in the angiocardiography, and the failure of the pulmonary artery banding were related to the blood cyst 4 mm. in diameter attached to the atrial surface of the anterior tricuspid leaflet near the free margin. The microscopic findings of haemosiderin loaded macrophages and calcified deposits in the haemorrhagic cyst speak in favour of its relatively ancient nature, not associated with an asphyxial mode of death.